This invention relates generally to a colostomy apparatus for evacuating fecal matter, and more particularly relates to a temporary colostomy apparatus for totally diverting the fecal stream.
A colostomy is a vent in the colon for the purpose of evacuating fecal matter and gas. Depending upon the patient's specific condition, the colostomy may be permanent or temporary. A temporary colostomy can be constructed to partially or totally divert the fecal stream.
In the past, a colostomy generally required that the bowel be extended out from an abdominal incision. A colostomy pouch usually supported by a belt or girdle was kept constantly in position to receive the fecal matter discharged during the colostomy. This arrangement is extremely objectionable due to the frequent escapage of foul odors and leakage of the fecal matter onto the body and wearing apparel. Sometimes instead of a belt or girdle, the colostomy bag was fixidly positioned against the outside of the abdominal wall with an adhesive. The adhesive often caused irritation, which chafed or maserated the abdominal skin.
U.S. Pat. No. 3,838,782
In U.S. Pat. No. 3,838,782 (1974) entitled "Temporary Colostomy Tube", an improved device and method were disclosed for overcoming the aforedescribed objectionable previous means for temporarily diverting the fecal stream. The prior colostomy device included an open ended excrement tube having an inflatible balloon secured on the fecal receiving end of the tube.
A non-absorbable band was wrapped around the outside of the colon at a selected location. The tube was inserted in the colon so that the balloon was further inward but adjacent the band.
The balloon was inflated with air to provide a circumference slightly larger than the band and together with the tube occupied the entire vertical space inside the colon. The inflated balloon abutted the band with a common portion of the colon sandwiched therebetween.
A retainer ring was positioned on the disposal end of the tube and pressed against the outside of the body. A disposal bag was fastened around the tube disposal opening for collecting the fecal matter. When normal colon and rectal bowel functions could be resumed, the balloon would be deflated and the excrement tube removed from the colon. The band would not be removed from inside the body and would remain wrapped around the colon.
The material of such prior band was not dissolvable inside the body, but was formed from material known not to react adversely in the body. To remove the band, another operation would be required--causing undesirable additional stress and shock to the body of the patient.
Surgeons and professional persons involved with colostomies appreciated the improvement of my prior temporary colostomy device, but, nevertherless heretofore, have been reluctant to consider use of my prior improved device with humans. They were primarily concerned with the possibility of future unforeseen problems that could arise from the permanent retention inside the body of the band around the outside of the colon. This objection has been overcome by the invention herein which provides a band that dissolves and is absorbed and excreted from the body, after the excrement tube is no longer necessary for diverting the fecal stream and had been removed from the body.
In the prior colostomy tube device, the air inflated balloon inside the colon would partially deflate over time to produce movement and instability of the excrement tube inside the colon. This would cause seepage of the fecal stream around the periphery of the balloon and consequently the fecal stream was not fully diverted inside the tube. To solve this problem, liquid is preferably used for inflating the balloon. As an additional safeguard against premature deflating of the balloon, a one way valve is positioned inside the liquid flow pathway to prevent any liquid back flow out from the balloon.
Another defect of the prior temporary colostomy tube device was the possibility that the neck of the disposal bag on the outside of the body would fold or twist to the side and press against the planar circular edge at the disposal end of the excrement tube to form a closal seal and block outflow of the fecal stream. The fecal stream unable to find a flow path into the disposal bag would build up sufficient pressure around the outside of the balloon to cause seepage into the surgically sore areas in the colon or bowel, thereby increasing the liklihood of infection. To overcome this, spaced notches are formed in the outer edge at the disposal end of the excrement tube, to prevent the formation of a seal against fecal flow by the disposal bag.
Moreover, an alternate disposal bag without a neck portion is provided which snaps on to the disposal end of the excrement tube, thereby minimizing any possibility that the bag itself would form a closure across the disposal opening of the tube.